Patient education: Facial fractures (The Basics)

What are facial fractures? — 

A fracture is a broken bone. A facial fracture is when a person breaks 1 or more bones in their face (figure 1).

Facial fractures can happen when a person is hit hard in the face. Common causes include sports injuries, car or bike accidents, and falls. Violence, like being hit in the face by another person, can also cause fractures.

There are different kinds of facial fractures, depending on which bone is involved and how it breaks. Some are more serious than others. A fracture is "displaced" if the bone is pushed out of its normal position. It is "non-displaced" if the bone has a break or crack but stays in place.

Facial fractures can lead to other problems. For example:

●If a muscle or nerve is injured, this can affect a person's ability to move or feel part of their face.

●Depending on where the fracture is, it might affect a person's breathing, seeing, speaking, or hearing.

●If a person has a serious head injury in addition to their facial fracture, this can lead to other serious problems. These can include brain damage, bleeding in the brain, infection, or seizures.

What are the symptoms of a facial fracture? — 

Symptoms can be mild or severe, depending on where the fracture is, how serious it is, and whether the person also has a head injury. Possible symptoms can include:

●Pain, bruising, or swelling – Sometimes, it takes a day for swelling to start.

●Changes to how the face looks – For example, the nose or jaw might be crooked, or the eyes might not line up.

●Headache

●Feeling very tired, confused, or dizzy

●Bleeding from the nose or ear

●Clear fluid draining from the nose or ear – This might be spinal fluid, which is the fluid that surrounds the brain and spinal cord.

●Vomiting

●Trouble smelling, hearing, or seeing (such as blurry vision in an eye or double vision when looking up)

●Weakness or numbness of the face

Is there a test for a facial fracture? — 

Yes. The doctor will ask about your symptoms and injury, and do an exam. To look for a fracture, they can do a CT scan of your face. This is an imaging test that creates pictures of the bones in the face and skull.

Depending on the type of injury, the doctor might also do other imaging tests. The tests you get also depend on whether you might have other problems like a head injury.

How are facial fractures treated? — 

It depends. If you have a small fracture and the bones stayed in place, it might heal on its own without treatment.

For people with severe fractures or other problems, treatment depends on the type of fracture and where it is. This might require staying in the hospital. For example:

●Fractures around the eye – If the bone around the eye is fractured, the doctor will check the eyeball for injury. They will also check the person's vision and how well they can move their eyes. If there is serious injury, the doctor might need to do a procedure to relieve pressure in the eye. Surgery might also be needed.

●Fractures around the nose – If the injury pushed the nose bones out of position, the doctor might have to put them back into place. They can sometimes do this using their hands or special tools. If this doesn't work, the bones can be put back into place with surgery.

●Fractures of the cheek bone – Fractures in this area are often displaced. This usually requires surgery to keep the normal shape of the face.

●Fractures around the mouth or of the jaw bone – If any teeth fell out or are loose, a doctor or dentist might have to fix this. Sometimes, teeth can be put back into place. If the person cannot open their mouth normally, a procedure or surgery might be needed to put the jaw back into the correct position. In some cases, the person will need to eat only soft foods while the fracture heals. With more serious fractures, the jaw might need to be held closed (with special elastic or wire) for a few weeks to heal.

If the person has cuts or open wounds on the face, they might get antibiotics or vaccines to prevent infection.

How do I care for myself at home? — 

To care for yourself or your child at home:

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

●Prop your head and shoulders on pillows, keeping it above the level of your heart. This might help lessen pain and swelling.

●Take all your medicines as instructed:

•The doctor might recommend you take an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

•You might have gotten a prescription for an antibiotic or stronger pain medicines to take for a short time. Follow all instructions for taking these.

●Ice can help with pain and swelling – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin. Ice for at least 6 hours after the injury. It might help to ice longer, even up to 2 days.

●If you have cuts in your mouth, ask your doctor about gargling with salt water to help the cuts heal.

●Try not to sneeze. If you need to, sneeze with your mouth open. This will help keep the pressure to your face and skull low and prevent causing more problems.

●Do not blow your nose. Dab your nose gently if needed.

●Depending on the type of fracture, you might need to eat soft foods or change your diet for a while. Try to include plenty of calcium, vitamin D, and protein (figure 2).

●Quit smoking, if you smoke. Your doctor or nurse can help. Broken bones take longer to heal if you smoke.

When should I call the doctor or nurse? — 

After the person with the fracture goes home, call the doctor or nurse if they have:

●Nausea or vomiting

●A headache that won't go away

●Fever

Take the person to the emergency department right away if they:

●Have a sudden, severe headache

●Have a seizure

●Have trouble walking, talking, or seeing

●Have weakness or numbness in their body

●Aren't acting like themselves

●Have blood or fluid leaking from their nose or ear

●Pass out

How can I try to prevent facial fractures? — 

You should:

●Wear safety gear, like a helmet, goggles, or a face mask, when you play certain sports. Wear hard hats and protective gear if you work in construction or a job where you work in a high place.

●Wear a helmet when you ride a bike, skateboard, scooter, or motorcycle.

●Always wear a seatbelt when riding in a car.

●Teach children not to slide head-first on sleds or slides or when playing baseball. Follow all rules at water parks.

More on this topic

Patient education: Skull fractures (The Basics)
Patient education: Nose fracture (The Basics)
Patient education: Head injury in adults (The Basics)
Patient education: Head injury in children and teens (The Basics)
Patient education: Head injury in babies and children under 2 years (The Basics)
Patient education: Concussion in adults (The Basics)
Patient education: Concussion in children and teens (The Basics)
Patient education: Full liquid diet (The Basics)

Patient education: Head injury in children and adolescents (Beyond the Basics)